Looking after your feet, skin, eyes and more

Look after your body with our handy practical guide

November, 2017

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Type 2 diabetes can have a negative effect on several aspects of your health. But just like lots of things about Type 2 diabetes, the good news is that there is something you can do about it. A healthier lifestyle can help you in lots of ways at once: you’re really doing yourself a massive favour to do a bit of exercise and cut down on unhealthy habits, because it will not only help to get you fitter and slimmer (if you need to get fitter and slimmer), but is also doing a lot of work behind the scenes to keep your whole body functioning well, for years to come.

Looking after your heart: cardiovascular disease

The problem

If you have Type 2 diabetes you’re more likely to develop heart disease or have a stroke than someone without diabetes. This is because if you have Type 2 diabetes you are more likely to have some of the risk factors for heart disease and stroke. The risk factors (things that increase your chances) include:

  • Raised blood glucose levels
  • Raised blood pressure
  • High LDL (“bad”) cholesterol
  • Being overweight

Blood Glucose

Getting your blood glucose to a healthy level is key to staying healthy. Read more about how to do that in our article Getting Blood Glucose Down

What you can do about it

Make sure you have regular check-ups with a healthcare professional to keep an eye on your blood pressure, cholesterol and weight. In addition:

Lower your blood pressure

Blood pressure can be lowered in a number of ways:

  • Losing weight if you are overweight
  • Keeping physically active
  • Reducing alcohol
  • Limiting salt intake – try garlic, herbs or black pepper for flavour instead
  • If needed, there are medications which will help to reduce your blood pressure
Reduce your LDL cholesterol

Cholesterol levels can be reduced by:

  • Eating more heart-healthy foods
  • Reducing alcohol intake
  • Keeping physically active
  • Taking regular exercise
  • Giving up smoking
  • If needed, there are also medications to help lower your cholesterol

Don’t know your BMI? (Body Mass Index)

Find out if you’re in a healthy weight range with the NHS weight calculator

Lose weight

Ideally, you’ll have a BMI between 20-25. You can try to lose weight by:

  • Reducing the fat in your diet
  • Limiting alcohol to no more than one unit per day
  • Keeping physically active
  • Taking regular exercise
  • Eating more fruit and vegetables
Stop smoking

If you do smoke, it is very important that you stop. There is plenty of help available to help you stop smoking, and your healthcare team will be available to help find what is best for you. If you have a family member or a close friend who can also help you to keep on top of your habits don’t be afraid to ask them for support, as this will help to keep you motivated and on target. Smoking when you have Type 2 diabetes can also increase your chances of having problems with your feet.

Try the Better-Living app

Take up the challenge of making one small change into a new healthy habit – for life. You can choose your own goals and track your achievements. The app is free and easy to use, and available on iOS and Android now.

Looking after your feet

The problem

Foot problems are common for people with Type 2 diabetes. Three out of ten people with diabetes develop foot ulcers. They are the most common reason for people with Type 2 diabetes to be admitted to hospital.

Foot ulcers usually develop from just a small injury to the foot and can take a long time to heal. They can also become infected, making healing more difficult. In rare cases, an ulcer can lead to serious problems like gangrene, which can even result in needing drastic surgery.

How foot ulcers develop

Having higher than normal blood glucose levels can, over time, cause damage to nerves. Nerve damage can reduce the feeling in your feet. Shoes can rub or cut into your feet without you realising, you may not feel hot water, or even a burn.

Raised glucose levels can also damage the small blood vessels in your body, which can reduce the blood supply to your feet. This can, in turn, result in your feet receiving less oxygen and other nutrients. Your skin can become frail, and more prone to injury. Once you get a cut or injury it takes longer than usual to heal.

What you can do about it

The good news is that if you check your feet daily, you might catch problems early, and early intervention can help to avoid problems from developing. Remember to tell your doctor or diabetes nurse about any changes or loss of sensation in your feet as soon as possible. You should also get at least one foot check per year with a healthcare professional.

There are also many things you can do to look after your feet:
  • Wash and check your feet daily
  • Make sure you dry them thoroughly, especially in between the toes
  • Massage your feet regularly with an emollient cream to prevent hard, dry and cracking skin.
  • However, avoid putting this between the toes which are normally moist enough already, as excess moisture could lead to fungal infections
  • Corns and hard skin may need to be treated by a registered podiatrist. Ask the practice nurse or doctor for an appointment
  • Don’t walk around barefoot
  • Keep your feet and legs away from very hot water, radiators, fire and extremes in temperature. You can easily damage your skin without realising
  • Use a mirror to check the undersides of your feet
  • Cut your toenails regularly, and carefully, after a shower or bath when they are soft. Don’t cut down the corner of the nail or dig down the sides. Cut straight across following the shape of the toe, and file the nail afterwards
  • Wear comfortable and properly fitting shoes
  • Feel inside your shoes for any roughness, hard ridges, prominent seams, nails or stones
  • Check your feet for any redness, which indicates pressure
  • Ridges or seams in socks and tights can cause blisters, which can become foot ulcers, so make sure they’re not too tight
  • Ask about using support socks, particularly if you are travelling long distances by plane

Looking after your skin

The problem
When blood glucose levels are high:

1. The body loses fluid. Some of the fluid is lost from the skin, which causes the skin to dry out. This can lead to other problems because:

  • Dry, flaky skin may feel itchy – if you scratch your skin it may become sore
  • Dry skin is also more likely to crack, allowing germs to get in, which can cause infections
If your skin is dry and cracked, applying moisturiser may help.

2. You may be less able to resist infections and the time for your body to respond and heal will be slower. This can increase the risk of skin infections, boils, and spots, which may take a long time to heal

3. The nerves in your legs and feet may become damaged, which can be painful. You may also not be able to feel pain, heat, or cold in those areas – this is called diabetic neuropathy. Type 2 diabetes may cause the blood vessels in your feet and legs to narrow, and harden, resulting in poor blood circulation.

What can you do about it
  • Bathe or shower in warm rather than hot water
  • Avoid long or too-frequent exposure to soaps and detergents as this can cause loss of oil from the skin, and cause more dryness
  • Try a soap substitute such as aqueous cream to wash your hands, or shower oils for all over
  • Use a moisturiser designed for dry skin
  • Dry yourself properly, and wear cotton next to your skin as it allows air to circulate better than synthetic materials
  • Try not to let your home become too dry (which can be caused by central heating). Using a humidifier can help to prevent this, but can lead to the house becoming too damp if it’s used too much.

If you think you may have a skin problem, make an appointment to visit your doctor. If it’s a problem with the skin on your feet, make an appointment to visit your podiatrist.

Looking after your nerves: neuropathy

The problem

Neuropathy is damage to the nerves of the body that carry signals from the brain, and the spinal cord to the muscles, skin, blood vessels, and organs. Neuropathy is a very common complication of diabetes, and while it can lead to unpleasant symptoms, many people with diabetes may not be aware of it. There are 3 main kinds of neuropathy:

Sensory neuropathy
  • Sensory neuropathy is the most common type of neuropathy, affecting about 50% of people with Type 2 diabetes
  • The nerves to the skin and muscles become damaged, causing a disruption of sensation to touch/heat, and pain, which can lead to injury and the potential for infection or ulcers
  • The symptoms of sensory neuropathy include;
    – pain
    – numbness
    – tingling in the hands, legs, or feet
    – extreme sensitivity to touch
 Autonomic neuropathy
  • Autonomic neuropathy is less common, and affects the nerves that control involuntary activities of the body, such as the stomach, intestine, bladder, sexual organs, and heart
  • Because autonomic nerves control so many different organs, symptoms vary depending on which organ is being affected
Motor neuropathy
  • Motor neuropathy is very rare, and affects the nerves that supply the muscles
What you can do about it

There are lots of options available to treat diabetic neuropathy. These include improving the control of your Type 2 diabetes or taking some medications. The most important thing to remember is to take your treatment as recommended by your health care provider.

Prevention
  • The best way to reduce your risk of developing neuropathy, or to prevent it becoming worse, is to control your blood glucose levels. This means keeping to between 4-6 mmol/l before meals and up to 10 mmol/l 2 hours after meals
  • Following a healthy, balanced diet, ensuring your prescribed medication is taken properly, and undertaking some form of regular physical activity are all important factors that will help to keep your blood glucose levels well controlled

Looking after your eyes: retinopathy

The problem

Diabetic eye disease can be very serious. It can lead to blindness if it cannot be controlled or is not treated in time. It doesn’t only occur in older people – it is very common in people with Type 2 diabetes who are of working age.

Causes

Diabetic eye disease (also known as retinopathy) occurs when tiny blood vessels in the eye are damaged. This is often a result of poor control of blood glucose (sugar), and blood pressure levels.

What you can do about it

If you have been prescribed medication for your blood glucose or high blood pressure, it’s important to take it according to the instructions.

Each time you visit your healthcare provider your blood pressure may be checked, as blood pressure is linked with pressure in your eyes.

Prevention

Controlling your blood glucose and blood pressure levels will reduce your risk of developing eye disease.

It’s important that you have your eyes photographed for retinopathy every year to check for signs of eye disease, so that action can be taken to help reduce your symptoms.

If you do have signs of eye disease, you may be checked more often.

Eye drops will be put into your eyes to dilate/enlarge the pupils. The eye drops may sting and affect your vision for a few hours, so:

  • Do not drive to the appointment
  • Wear sunglasses after the test if it is a sunny day
  • Ask a friend or relative to go with you if you are unsteady on your feet

In addition to your annual eye check you may also need to have your eyesight tested each year. This will be carried out at your optician’s and will assess your near and distant vision, and may include a test for glaucoma.

Looking after your kidneys: nephropathy

The problem:

The longer you have Type 2 diabetes the more likely you are to develop some level of kidney damage (also known as nephropathy). Over time, Type 2 diabetes can damage the small blood vessels in the kidneys, which means that they become less efficient at filtering out waste products. A sign of this is protein leaking into the urine. This is hard to identify, and this can really only be tested by testing the urine, which your nurse should do at least once a year. However, if you have signs of kidney disease this will be checked much more often.

Kidney damage increases your risk of coronary heart disease and stroke. Well controlled blood glucose levels and normal blood pressure can help slow down the progression of kidney disease. Smoking can contribute to the worsening of kidney disease.

What you can do about it

Working to control your blood pressure is a key part of looking after your kidneys. You will also need to think about the dietary and physical activity recommendations made by your nurse, doctor or dietician.

Controlling your blood glucose and blood pressure levels will reduce your risk of developing kidney disease or may help to stop your kidney disease becoming worse.

Looking after your sex life

The problem:

For women, poorly controlled diabetes can damage blood vessels and the nervous system, which can reduce blood flow and sensation in the sexual organs. This can also contribute to vaginal dryness, making sex uncomfortable. On top of that, having high blood glucose means you are more prone to infections such as thrush.

For men, a common sexual problem is erectile dysfunction or impotence. This affects a lot of men, but is especially common in men with Type 2 diabetes. It may be caused by the physical factors of Type 2 diabetes, or the medication you take, lifestyle factors or your psychological state – or a combination of any of these. Poorly controlled diabetes can damage blood vessels and the nervous system, which can reduce blood flow and sensation in the sexual organs.

What you can do about it

Getting control of your Type 2 diabetes and improving your lifestyle are a big part of improving the problem. You could see a psychosexual counsellor if you think it may be to do with how you’re feeling, and there are also a number of therapies available for men and women that can help. Ask your doctor or specialist nurse if you’d like to explore any of these options. There’s no need to be embarrassed – they’re healthcare professionals who see this kind of thing all the time, and will treat it like any other health-related condition.